I have PA, but I also have a couple of other things going on that can cause fatigue & fog. So when I have a bad day, I'm not 100% sure it's due to my B12 being low.

I'm fortunate in that my doctor's nurse has trained my husband to give me the injections, so I can have one whenever I feel the need (I'm in the U.S. so it's cyanocobalamin, and the normal protocol is once a month).

So my question is for those of you who do have to wait for your jab, and feel the effects well beforehand. From the time you first feel the symptoms until the time you get the jab, do your symptoms get worse in a linear fashion? In other words, is each day worse than the last? Or do the symptoms ebb and flow, but in a generally downward direction?

The reason I ask is that I'm wondering if it's too my advantage to go running to the needle at the first sign of symptoms, or wait a day or so to see if it was something else after all.

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I have been on four weekly cyanocobalamin injections for 45 years and down through the years I noticed a return or or worsening of symptoms in the third and fourth weeks and six years ago I attempted to persuade my "one size fits all" GP to increase the frequency. His only concession was to allow an occasional three week jab a couple of times a year.

This year I took advantage of his being on holiday to see another doctor in the practice and although she was originally reticent eventually agreed (because of my symptoms) in July to change my regime to every threes weeks permanently.

sorry it is so long since I waited to top up B12 that I really can't remember.

I have sveral symptoms that mark needing more B12 which include - stiffness in ankles, generally cranky, not being able to grip properly. Sometimes these can be signs I'm coming down with an infection (so may need more B12 for that). I've just got used to keeping levels high because that is what I need to do to function and there isnt' a problem with keeping them high.